Dilatation of biliary stricture

Uncommonly, biliary strictures can be dilated. Situations that may warrant this approach may include:

• benign or malignant growth strictures
• post-traumatic surgical strictures
• strictures in sclerosing cholangitis
• strictures proximal to a sphincterotomy

Both a 7 F tapered dilating catheter and a balloon catheter system have been used. The former is preferred for tight strictures, the latter for more accurate localisation of site since contrast media can be injected into the balloon. Both are directed to the stricture by a guidewire passed down the endoscope.